'A Juggling Act': an analysis of the impact of providing clinical placements for pre-registration students on the organisation of community nursing and health visiting work.

Modernising policies for the NHS have aimed to strengthen the nursing workforce through enhancing professional roles and increasing the numbers of pre-registration students. The current emphasis upon community based health care has led to an increase in the quantity and complexity of the workload for community nurses and health visitors, whilst at the same time educational developments have led to additional responsibilities supporting nursing students on community placements. These issues are explored in this paper which reports findings from a qualitative study in a large city based Primary Care Trust (PCT). The findings demonstrate that the provision of clinical placements for nursing students leads community nurses and health visitors to juggle the demands of their workload with meeting the needs of nursing students and clients. This requires a (re)-organisation of their work, often impacting on the wider team. Additionally the nature of community nursing/health visiting work, shaped by time, space, resources and location, constrains opportunities for clinical learning. If government policies are to be implemented successfully, community nursing and health visiting staff require appropriate support to enable them to fulfil their educational and clinical roles.